Rosalita Allen was driving to pick up one of her granddaughters just before noon on Thanksgiving last year when she noticed flashing police lights and a blocked road straight ahead.
"I thought, 'Oh my dear god, somebody had a horrible accident,'" Allen said. "I had to turn left. From the time I turned left to the time I got to my granddaughter, I was praying for the accident victim, not knowing it was my daughter and that she was already dead."
Her daughter, Tammy Allen, 41, had been on her way to pick up her then-16-year-old son and go to Rosalita's for the holiday. Four blocks away, Tammy clipped another car as she tried to change lanes, sending her into oncoming traffic. She hit two vehicles, one of them head-on, according to the Associated Press.
Tammy died instantly at 11:38 a.m., Rosalita said.
Fatal Accidents More Likely on Thanksgiving
Thanksgiving was the deadliest holiday in 2010, according to the most recent data available from the National Highway Traffic Safety Administration. That year, 431 people died on the roads nationwide, compared with 259 on Christmas, 403 on Labor Day and 392 on Fourth of July.
"Whenever you increase the number of people traveling, and the number of cars, your likelihood and chance of having an accident are going to increase just by statistics," said Dr. Rahul Sharma, who heads NYU Langone Medical Center's Emergency Department and has worked his fair share of holidays in the ER.
An estimated 90 percent of Thanksgiving travelers will drive to their destinations this Thursday, according to the AAA auto club. That's 39.1 million people on the roads.
Sharma said car accident injuries can vary depending on what time the accident happens. During the day, when roads are gridlocked, collisions happen at lower speeds and result in more minor injuries, including bruises and neck injuries.
"If there were to be a silver lining, that would be it," said Jake Nelson, AAA's Director of Traffic Safety Advocacy and Research. "I'm not sure anyone would pray for congestion though."
Late at night, however, ER doctors start seeing more serious injuries as travelers are able to go faster on the emptying roads, Sharma said. The holiday alcohol and distracting family drama can also contribute to slower reaction times.
And as it gets later, more impaired drivers get behind the wheel, said Dr. Curt Dill, who also works in the NYU emergency room. He said that 11 p.m. to 4 a.m. are normally the worst hours, but by 2 a.m. on Thanksgiving, drivers might be traveling so fast that they look like they're "drag racing," causing cars to lose control and even flip over.
Dill said injuries depend on whether drivers are wearing their seat belts and how fast they're speeding.
"If you're wearing a seat belt and driving a modern vehicle with restraints on, then lots of collisions are survivable," he said. "But if you're not wearing your seat belt, you're crashing into a several -ton piece of metal."
That means, broken bones, internal bleeding, head injuries and even death.
Seat belts reduce the risk of fatal injuries in cars by 45 percent, according to AAA. In "light" trucks, they reduce that risk by 60 percent.
More Fatal Accidents in Rural Areas
Neither Tanya McCoy nor her 10-year-old son, Andrew, were wearing their seat belts as they left their Bonners Ferry, Idaho, home at 7 a.m. on Thanksgiving 2010. Sean McCoy, Tanya's husband, described her as a "short, little redhead who was pretty fiery." She was also a triathlete.
Tanya was on her way to help out with a Thanksgiving Day run called the Turkey Trot.
"Of course she was in a hurry. She was always in a hurry," Sean said.
Just two miles from home, Tanya came to a hill she'd traveled hundreds of times, but this time, there was a patch of black ice. The car skidded across the road, hit a barricade and tumbled 300 feet to the bottom of a canyon, where she and Andrew were ejected from the car.
But no one saw them.
When the race ended and they didn't come home by 1 p.m., Sean became worried. The sheriff tried to help, but no one could find them. Finally, Sean saw the tire marks on the barricade. Looking into the canyon, he saw a piece of the car.
"I ran to the bottom and that's when I found them," he said, adding that they were both barely alive and hypothermic. "I ripped my son's clothes off of him and put clothes around him, and he died. I gave him CPR, and he came back around again."
Neighbors came out to help, but the helicopters couldn't land in the bad weather. It would take hours for the ambulance to get there.
The hospital was able to keep Andrew alive, but Tanya died in Sean's arms. Both had brain injuries, but the hyperthermia helped keep Andrew's brain from fatally swelling, crushing itself against his skull.
Now 12, Andrew is back at school as the star pitcher on the baseball team. He lost his mother, spent two weeks in a coma and has problems moving his left side because the right side of his brain was affected, but he's about 90 percent back to normal, Sean said.
Sean said he doesn't know what he would have done without his tight-knit community, family and friends over the last two years.
According to AAA, 67 percent of all fatal accidents happen in rural areas, in part people are less likely to wear their seat belts there. But people also die because it can take a long time for help to arrive after a crash.
Nelson said the "golden hour" refers to the need for trauma patients to receive care in the first 60 minutes to increase their chances of survival. But in rural areas like Bonners Ferry, medical care and fast treatment can be harder to come by because hospitals are farther away.
Advice to Travelers
Even Dill, with his ER career, said he's been at fault for making the wrong decision during holiday travel.
One Christmas, with his pregnant wife in the passenger seat, Dill was speeding and drove off the road on the way to dinner. He and his wife were shaken because they could have died, but everyone was fine.
"I was rushing to get to her folks' house," Dill said. "I'm a pretty safe, cautious person who knows people can get hurt in cars."
He said he realized that people don't recognize how the holidays can make them drive too fast for the road conditions. His accident was a wake-up call, and it's something he tells his patients about because they sit up and pay attention.
"Just because you're late for meal, slow down because you'll be a lot later if you'll get in a car accident," Dill said.
Dill and Nelson reminded drivers to buckle up because they can't control other people on the road, but they can drive the speed limit and be vigilant.
"You have to drive knowing that you're going to be passing people who are impaired, who are rushing, who are intoxicated," Dill said.
Sharma said the best advice for anyone who has been in an accident is to stay still until help arrives unless the car is on fire. Neck injuries can be made worse by moving, so one of the first things first responders do is immobilize crash victims with a back board.